Internal medicine journal
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Internal medicine journal · Jun 2012
Randomized Controlled Trial Comparative StudyComparison of empirical continuous positive airway pressure (CPAP) treatment versus initial portable sleep monitoring followed by CPAP treatment for patients with suspected obstructive sleep apnoea.
Polysomnography is labour-intensive for diagnosing obstructive sleep apnoea (OSA). We compared two algorithms for initiating continuous positive airway pressure (CPAP) treatment for patients with suspected OSA. ⋯ An ambulatory approach with portable sleep monitoring for diagnosing OSA before a CPAP trial can identify more patients who would adhere to CPAP at 6 months than empirical CPAP treatment alone.
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Internal medicine journal · Jun 2012
Implementation of standardised surveillance for Clostridium difficile infections in Australia: initial report from the Victorian Healthcare Associated Infection Surveillance System.
Detection of a hypervirulent strain of Clostridium difficile in Victoria led to commencement of targeted surveillance for C. difficile infection in 2010. Cases were reported through the Victorian Healthcare Associated Infection Surveillance System. ⋯ Data reflect successful implementation of continuous surveillance for C. difficile infection. With hypervirulent C. difficile infection now reported in other Australian states, development of a national data repository for C. difficile infection is necessary.
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Internal medicine journal · Jun 2012
Identifying patient-specific beliefs and behaviours for conversations about adherence in asthma.
Asthma guidelines advise addressing adherence at every visit, but no simple tools exist to assist clinicians in identifying key adherence-related beliefs or behaviours for individual patients. ⋯ This study identified several specific beliefs and behaviours which clinicians could use for initiating patient-centred conversations about medication adherence in asthma.
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Internal medicine journal · Jun 2012
Mediastinal staging of non-small-cell lung cancer among Australasian thoracic physicians: clinical practice and constraints on minimally invasive techniques.
We determined current practice among Australasian thoracic physicians in the mediastinal staging of non-small-cell lung cancer (NSCLC). We focused on the availability of endobronchial ultrasound-transbronchial needle aspiration (EBUS-TBNA) and constraints to its use, as there has been no systematic analysis regarding the availability and uptake of this new technology among thoracic physicians. ⋯ Australasian thoracic physicians prefer EBUS-TBNA for the mediastinal staging of NSCLC, but access to EBUS-TBNA services is limited. We recommend targeted measures to improve access to EBUS-TBNA use and optimise mediastinal staging of NSCLC.